![]() ![]() The physician expects to kill but does not intend to do so. The physician regrets this result but can avoid it only by so reducing the dosage that the chemical will not have sufficient painkilling effect. For example, the Encyclopedia of Bioethics presents as a standard illustration of the PDE the following scenario:Ī physician seeks to alleviate a patient's pain by administering the painkiller morphine but recognizes that the dosage is likely to shorten the patient's life. In bioethics, the principle of double effect (PDE) is used to justify the administration of medication to relieve pain even though it may lead to the unintended, although foreseen, consequence of hastening death by causing respiratory depression. The concept of double effect of opioids also has been used in support of legalization of physician-assisted suicide and euthanasia. Applying the principle of double effect to end-of-life issues perpetuates this myth and results in the undertreatment of physical suffering at the end of life. Although a review of the medical literature reveals that the risk of respiratory depression from opioid analgesic is more myth than fact and that there is little evidence that the use of medication to control pain hastens death, the belief in the double effect of pain medication remains widespread. The principle of double effect is used to justify the administration of medication to relieve pain even though it may lead to the unintended, although foreseen, consequence of hastening death by causing respiratory depression. Reproduced with permission of the author and the publisher, Mary Ann Liebert Inc, from Journal of Palliative Medicine 1998 1: 315-28. The Double Effect of Pain Medication: Separating Myth from Reality Statements on Euthanasia and Physician Assisted Suicide.What are the relevant International Conventions and Treaties and why are they important?.Palliative Care and Covid-19 Series - Briefing Notes Compilation.Palliative Care Advocacy: Why Does It Matter?.The IAHPC: Advancing Hospice and Palliative Care Worldwide.Palliative Care in the Developing World.IAHPC Special Issue on Assisted Dying Practices.Advocacy Course for global, regional, and national advocacy for palliative care.Comprehensive Symptom Assessment and Management Course.Pallipedia: Online Palliative Care Dictionary.Palliative Care and Covid-19 Series (2020).Global Directory of Educational Programs in Palliative Care.Global Directory of Palliative Care Institutions and Organizations.Global Data Platform to calculate SHS and Palliative Care Need.Consensus-Based Definition of Palliative Care (2019).IRS Public Charity Determination Letter.
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